• The Korean Society of Law and Medicine
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• v.5 no.2
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• pp.294-319
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• 2004

Because the treatment of a physician generally pertains to the intrusion into body of a patient, his/her consent is a must in order for such conduct to be justifiable. To ensure effective consent of a patient, the physician should fully inform him/her of kind and details of the disease and way of treatment and risks associated with it. The patient can, then, make a decision whether he/she should accept any treatment or operation, if necessary, on the basis of such information. The obligation of physicians to explain has since long been recognized as important in view of guaranteeing the rights of patients for self-decision and protecting them from arbitrary assessment of physicians for treatment. Progress has been made in this respect even to the extent that physicians treat patients on equal terms and think first of all much of establishing trustworthy relationships with patients. Lots of studies in Korea and foreign countries have tried to explore the issues concerning the obligation of physicians to explain in the meantime but seem to have failed to make concrete and versatile approaches from the standpoint of protecting the rights of patients. Wouldn't it be really possible for patients to perceive their own rights and cope actively with the medical treatments? If physicians have full understanding to the rights of patients, they will be put in a better situation to protect themselves and patients, in turn, can identify their own responsibility correctly, which will eventually contribute to fulfilling the goal of treatment. With this background, the present paper examines briefly the obligations of physicians for explanation based mainly on the preceding theories and judicial precedents in the first place and then deals with the status quo and contents of the German medical laws, with a focus on the treaty of European Law 1997 and its working document on the applications of genetics for health purposes that stipulate the detailed criteria on the medical treatment and rights of patients and Germany's $\ulcorner$Charter of Rights for Patients$\lrcorner$ promulgated in 2003.

• Safety and Health at Work
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• v.5 no.1
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• pp.27-31
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• 2014

Background: Carpal tunnel syndrome (CTS) is a common work-related peripheral neuropathy. In addition to grip force and repetitive hand exertions, wrist posture (hyperextension and hyperflexion) may be a risk factor for CTS among workers. However, findings of studies evaluating the relationship between wrist posture and CTS are inconsistent. The purpose of this paper was to conduct a meta-analysis of existing studies to evaluate the evidence of the relationship between wrist posture at work and risk of CTS. Methods: PubMed and Google Scholar were searched to identify relevant studies published between 1980 and 2012. The following search terms were used: "work related", "carpal tunnel syndrome", "wrist posture", and "epidemiology". The studies defined wrist posture as the deviation of the wrist in extension or flexion from a neutral wrist posture. Relative risk (RR) of individual studies for postural risk was pooled to evaluate the overall risk of wrist posture on CTS. Results: Nine studies met the inclusion criteria. All were cross-sectional or case-control designs and relied on self-report or observer's estimates for wrist posture assessment. The pooled RR of work-related CTS increased with increasing hours of exposure to wrist deviation or extension/flexion [RR = 2.01; 95% confidence interval (CI): 1.646-2.43; p < 0.01: Shore-adjusted 95% CI: 1.32-2.97]. Conclusion: We found evidence that prolonged exposure to non-neutral wrist postures is associated with a twofold increased risk for CTS compared with low hours of exposure to non-neutral wrist postures. Workplace interventions to prevent CTS should incorporate training and engineering interventions that reduce sustained non-neutral wrist postures.

• Physical Therapy Korea
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• v.21 no.4
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• pp.56-66
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• 2014

For maintaining adequate psychometric properties when reducing the number of items from an instrument, item level psychometrics is crucial. Strategies such as low item correlation or factor loadings, using classical test theory, have traditionally been advocated. The purpose of this study is to describe the development of a new short form assessing the impact of low back pain on physical activity. Rasch measurement model has been applied to the International Classification of Functioning, Disability and Health Activity Measure (ICF-AM). One hundred and one individuals with low back pain aged 19-89 years (mean age: $48.1{\pm}17.3$) who live in the community were participated in the study. Twenty-seven items of lifting/carrying construct of the ICF-AM were analyzed. Ten items were selected from the construct to create a short form. Item elimination criteria include: 1) high or low mean square (out of the range: .6-1.4 for the fit statistics), 2) similar item calibrations to adjacent items, 3) person separation value, and item-person map for potential gap in person ability continuum. All 10 items of the short form fit to the Rasch model except one item (i.e., carrying toddler on back). Despite its high infit and outfit statistics (1.90/2.17), the item had to be reinstated due to potential gaps at the upper extreme of person ability level. The short form had a slightly better spread of person ability continuum compared to the entire set of item. The created short form separated individuals with low back pain into nearly 4 groups, while the entire set of items separated the individuals into 6 groups. The findings prompted multidimensional models for better explanation of the lifting/carrying domain. The item level psychometrics based on the Rasch model can be useful in developing short forms with rationally retained items.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.46-66
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• 2018

Purpose : The purpose of this study was to systematically review the instruments utilized to assess physical impairment in post-intensive care syndrome (PICS) of intensive care unit (ICU) survivors. Method : Online databases searched were MEDLINE, Cochrane, CINAHL, and Embase. Studies that met the following criteria were included: 1) the study population exclusively had experience with ICU admission; 2) the study assessed pulmonary, neuromuscular, and physical functions; and 3) the study was published in English language journals after 2007. Results : A total of 56 instruments (2 pulmonary, 25 neuromuscular, 29 physical function) from 94 studies were reviewed. They were classified into self-report, observation, and measurement according to the type of assessment. No instrument measured all 3 areas of physical impairment. Five instruments were originally developed for the ICU patients. The most frequently applied instruments were the Medical Research Council and the 36-item Short Form Survey (physical component summary), which were used in 23 studies each. Only 13.8% of reviewed studies reported the reliability or validity of the instruments. Conclusion : Our results suggest that the appropriateness of instruments assessing physical impairment in PICS cannot be guaranteed. Despite the multidimensional concept of physical disabilities, most studies measured only one area, and studies that reported psychometric properties were limited. Accordingly, we propose to develop a unique and multifaceted instrument for ICU survivors.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.245-254
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• 2013

Purpose: This study was done to examine predictive validity of Critical Care Non-verbal Pain Scale (CNPS) and develop criteria for pain assessment using CNPS with critically ill patients who have communication problems. Methods: Data were collected from intensive care units at three major general hospitals in Seoul and Kyunggi province. During each observation, a nurse assessed pain severity using CNPS ratings (range 0-9) at four treatment stages: at rest, during central catheter dressing change (nonpainful procedure), position change and suctioning (routine painful procedures). Patients also assessed their pain using a self-report 4-point VRS-4. Results: There were significant differences between the four treatment stages except between "at rest" and "nonpainful procedure". Strong correlations were found between CNPS and VRS-4 for "at rest" (r=.552, p<.001), central catheter dressing change (r=.505, p<.001), position change (r=.709, p<.001), and suctioning (r=.662, p<.001). ROC curve analysis of CNPS based on 3 point on VRS-4 showed the cutoff point was 3 for CNPS, the starting point for pain management with 73% sensitivity, 92.2% specificity, 73% positive predictive value, and 92.8% negative predictive value. Conclusion: Results indicate that CNPS is a valid tool for measuring pain in critically ill patients with communication problems and 3 point should be the standardized pain treatment point.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.236-247
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• 2017

Purpose: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. Methods: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. Results: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. Conclusion: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.

• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.4
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• pp.29-36
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• 2016

Purpose: Considering the proportion of the population such as the elderly, pregnant women, infants companion and constantly increasing foreign tourists, there is a high need for implementing an environment without barriers. In terms of policy and institutional aspects, Jeju Special Self-Governing Province is striving to create an environment without barriers and to promote the safety and convenience of Vulnerable Pedestrians. But it is not enough to create a viable barrier-free environment. Methods: Method of this research is to analyze the general population status and installed facilities status for the disabled in Jeju. And analysis of policy research needs and level of barrier-free. By applying the barrier-free environment certification standards should conduct an assessment of the level of the current public office buildings in Jeju. It presents the environmental improvement of public office buildings for barrier-free environment. Result: Barrier-free environment status of the five public office buildings research surveyed all buildings have shown low levels of installed facilities for the disabled. In particular, it was analyzed that represents a very low level in the intermediate facilities and other facilities. The development of a specific installation manual for the facilities for the disabled is required to improve public office buildings. And barrier-free criteria need to reflect on the implementation of regulations. Implications: Through continuous research to analyze the barrier-free level and problems of public office buildings, it will be made to improve the comprehensive and reasonable alternative.

• The Journal of Sustainable Design and Educational Environment Research
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• v.18 no.3
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• pp.16-27
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• 2019

Based on basic studies on the current status index of BF certification application for school facilities according to the BF certification implementation, this study sought to improve the direction of the different BF certification evaluation indexes for school facilities by investigating and analyzing the status of BF Reservation Certification for elementary schools. A comparative analysis of the status and evaluation indexes of 30 elementary schools in the Gyeongsang region that included indicators of external and internal facilities, sanitary facilities, guidance facilities, and other facilities indicated that school facilities are insufficient to discriminate based on criteria and thus need to be updated for accurate grading. For school facilities that are open for anyone to use, quality improvement should be induced by improving standards and adjusting points for items that earn middle and lower grades.

• Journal of Information Technology Services
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• v.18 no.2
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• pp.55-73
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• 2019

The importance of the personal information has been increased, there have been a lot of efforts to establish a new policy, certification or law for administrating personal information more effectively and safely. Korean government has operated ISMS and PIMS certification system to assess whether an organization has established and managed appropriate information security system or not. However, it has been addressed the needs for revising and modifying of PIMS and ISMS. It is evaluated there are a few overlapped criteria to assess information management system in both ISMS and PIMS. ISMS-P certification, combining with ISMS and PIMS, is, finally, suggested, in the recent. GDPR is established having an aim of primarily to give control to individuals over their personal data and to simplify the regulatory environment for international business by unifying the regulation within the EU. This study compares GDPR and ISMS-P, focusing on "personal information". It can be expected to contribute as followings. This study can be a criterion for self-evaluation of possibility to violate of GDPR of a firm in preparation for ISMS-P. Second, this study also aims to increase the understanding of the role of ISMS-P and GDPR, among various certifications with the purpose of assessment of the information security management system, by reducing the costs required to obtain the unnecessary certification and alleviating the burden. Third, it contributes to diffusion of ISMS-P newly implemented in Korea.

• The Journal of Korean Medicine
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• v.43 no.4
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• pp.102-130
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• 2022

Objectives: The persistence and unpredictability of coronavirus disease (COVID-19) and new measures to prevent direct medical intervention (e.g., social distancing and quarantine) have induced various psychological symptoms and disorders that require self-treatment approaches and integrative treatment interventions. To address these issues, the Korean Medicine Mental Health (KMMH) center developed a field manual by reviewing previous literature and preexisting manuals. Methods: The working group of the KMMH center conducted a keyword search in PubMed in June 2021 using "COVID-19" and "SARS-CoV-2". Review articles were examined using the following filters: "review," "systematic review," and "meta-analysis." We conducted a narrative review of the retrieved articles and extracted content relevant to previous manuals. We then created a treatment algorithm and recommendations by referring to the results of the review. Results: During the initial assessment, subjective symptom severity was measured using a numerical rating scale, and patients were classified as low- or moderate-high risk. Moderate-high-risk patients should be classified as having either a psychiatric emergency or significant psychiatric condition. The developed manual presents appropriate psychological support for each group based on the following dominant symptoms: tension, anxiety-dominant, anger-dominant, depression-dominant, and somatization. Conclusions: We identified the characteristics of mental health problems during the COVID-19 pandemic and developed a clinical mental health support manual in the field of Korean medicine. When symptoms meet the diagnostic criteria for a mental disorder, doctors of Korean medicine can treat the patients according to the manual for the corresponding disorder.